NUTRITION ACROSS ALL AGES( PREGNANCY
AND LACTATION)
Pregnancy - growing fetus
- Pre- pregnancy, if the couple decide to
have the pregnancy, then the woman
would consult an ob gyne and then she
should take a folate. (about 400
micrograms or milligrams of the
folate).
- Can be taken 2 months of pre
pregnancy to prevent the NTD’S.
- Pregnancy= refers to the condition or
state of a woman carrying or developing
embryo or fetus within her body.
- Developing fetus inside the womb of
the mother.
- In order for the fetus to thrive the
mother needs enough nutrients
because the nutrients are being shared
to the baby.
- Saan dumadaan ang nutrients=
placenta
- Nutrition is very important in
pregnancy.
● Pregnancy (gestation) is a period of
great physiologic stress for a woman as
she is nurturing a growing fetus in her
body.
CHANGES THAT MAY OCCUR TO THE MOTHER
DURING PREGNANCY
● Some changes occur in the mother's
body which influences the need for
nutrients & the efficacy with which the
mother's body uses the nutrients.
A. Basal metabolic rate (BMR): Fetal growth &
development increases the BMR by 5% during
1st trimester and 12% during 2nd & 3rd
trimester. This increases the total energy
requirement. ( Nutrients divided by mother and
the baby).
- Mabilis ang metabolism because the
nutrients is being divided by the mother
and the baby.
- Increase 5% during the first trimester,
nag-i-increase ang BMR and 12% during
the second and third trimester. This
increases the total energy requirement.
- The increase of BMR is needed so that
the weight of the mother will increase
and also for the baby to develop inside
the womb.
B. Gastrointestinal changes: There is an
alteration in Gl functions which causes nausea,
constipation & vomiting. In the later trimester
of pregnancy absorption of nutrients like
vitamin B12, iron and meek calcium increases in
order to meet the increased needs of the
mother & fetus.
C. Changes in body fluid: Mother's blood
volume increases so as to carry the appropriate
amount of nutrients to the fetus and metabolic
waste away from the fetus. With increase in the
blood volume the concentrations of plasma
proteins, hemoglobin and other blood
constituents are lowered.
- Intake of nutrients and vitamins,
minerals are increased during this stage
of life.
- There's also a change in body fluid
because the mother's blood volume
increases kasi nag hati sila ng baby.
- Kailangan natin ang increase ang blood
to prevent anemia so not only the
blood, the iron is also needed.
WHAT CAUSES WEIGHT GAIN
BLOOD VOLUME- increases by about 4 pounds
PLACENTA- increase by 1 pound
AMNIOTIC FLUID- increases by about 2 pounds
BREAST- breast tissue increase by about 1-2
pounds
MATERNAL FAT- increases by about 4 plus and
up

UTERUS - Grows for about 2 pounds
DIET INTAKE
NORMAL WEIGHT GAIN FOR WOMEN DURING
PREGNANCY
● 3 and a half pounds for the first
trimester and 1 pound per week
● Tota weight gain of 25-35 pounds by
term
UNDERWEIGHT
● For first trimester, 5 pound and half to
1 pound per week
● 28-40 pounds per term
OVERWEIGHT
● During 1st trimester 2 pounds and 2/3rd
pounds per week
● Total of 15-25 pound by term
WOMAN CARRYING TWINS
● Weight gain should be around 35-45
pounds by term
- A large weight gain over a short period
of time first sign of Pre- Eclampsia
● PRE ECLAMPSIA- 140/100 ( her own tissues.
development of high blood pressure,
swelling, high levels of albumin in urine)
● ECLAMPSIA- 160/100 (development of
seizure)
OTHER CHARACTERISTICS OF PRE- ECLAMPSIA
● Characterized by hypertension
● Proteinuria
IMPORTANCE OF GOOD NUTRITION DURING
PREGNANCY
1. Mother has to nurture the fetus, health of
the newborn depends on nutritional status of
the mother during and prior to conception.
- Nutrition is very important for pregnant
women because it is needed to nurture
the fetus inside in order for the baby to
thrive, to grow normally.
2. A well nourished woman prior to conception
enters pregnancy with a reserve of several
nutrients that meets the needs of the growing
fetus without affecting her own health.
- If a mother is well nourished, the
mother may suffer fewer complications
during pregnancy and fewer chances of
premature birth.
- The baby will be born at a proper age,
at a proper time. So by 9 months,
manganganak na mother at hindi 7 or
6 months
3. A well nourished woman suffers fewer
complications during pregnancy & there are few
chances of premature births.
4. A well nourished mother will give birth to a
healthy child.
5. Maternal diet during pregnancy has a direct
influence on fetal growth, size & health of the
newborn.
6. Poor diet during pregnancy affects the
mother's health, a malnourished mother
provides nutrients to the fetus at the expense of
- Pag malnourished kasi ang mother, she
cannot provide enough nutrients for the
fetus. Hindi mag-grow ang fetus or will
not develop normally and properly=
Resulting SGA.
- SGA= SMALL GESTATIONAL AGE
- Too much= macrosomia or LGA
7. Poor nutrition during pregnancy increases the
risk of complications such as prolonged labor
and even death.
8. Inadequate diet during pregnancy affects the
health of the baby during early infancy. They
develop nutritional diseases like anemia, rickets
or suffer from Infectious diseases due to lack of
good immunity.
- SGA Small Gestational Age
- To prevent Anemia, Prolong labor,
Rickets etc
 - SGA, usually ang mga adolescent
mothers na may mga vices (drug
abusers, usually nagkaroon sila ng SGA
or mga babies with some complications)
NUTRITIONAL NEEDS DURING PREGNANCY
During pregnancy the nutrient needs increases:
1. To develop maternal organs such as uterus,
placenta and breast tissues
- Need ng mother and weight gain.
- It is not normal for a pregnant woman
to not gain weight during pregnancy
because everything will be increased.
2. To build up body reserves to be utilized at the
time of delivery and lactation.
3. During the 1st trimester there is no significant
increase in the size of the fetus thus only
qualitative improvement in nutrients intake is
required during this time.
4. 2nd & 3rd trimester: An increased nutrient
intake is suggested in the the second & third
trimester of pregnancy thus need for almost all
the nutrients is increased during pregnancy.
● Nutritional needs during pregnancy are
affected by the mother's age along with
height and pre-pregnancy weight.
● The national standard recommends an
increase of 340 kcal/day during the
second trimester and approximately
450 kcal/day during the third trimester
of pregnancy.
- The increase of nutrient intake during
the 2nd and 3rd trimester should be
about 340 Kcal on top of the
requirement per pregnancy.
- Third trimester= 450 kcal
● Protein intake should increase 25
g/day during pregnancy on top of
nonpregnancy needs. This increase is
approximately 50% more than the
average adult requirements.
- The protein intake should increase
because it is needed for the
development, the growth and
development of the baby ( nagkakaroon
ng anabolism)
- Building up of tissues, paano lalaki ang
bata kung walang protein
● Increased protein is necessary in
pregnancy for sparing
● carbohydrates for energy, rapid growth
of the fetus, development of the
placenta, growth of maternal tissues,
increased maternal blood volume, and
amniotic fluid.
● Iron needs are increased during
pregnancy for increased
- Iron is needed to increase because it is
divided between the baby and her and
that the baby is storing its iron store.(
needed to for the next 4 to 6 months of
life) ( Ibig sabihin, kailangan ng bata ng
iron after delivery because the sole
food of the baby is only the breast milk
which lacks in iron).
- Kulang sa iron ang mga breast milk and
even the infant formula. So that's why
the baby needs an iron store of its own,
needed for the first 4 to 6 months of life
in order to prevent the iron deficiency
anemia.
- Nagbibigay lang ng iron
supplementation during the 6 months
of life pero hindi lagi , kung anemic lang
ang bata.
● hemoglobin synthesis required for the
greater maternal blood
● volume as well as for the baby's
necessary prenatal storage of iron.
PROTEIN, CA, AND FE REQUIREMENT DURING
PREGNANCY
PROTEIN
● Growth of fetus
● Development of placenta
● Enlargement of maternal tissues
● Increased maternal blood volume
● Formation of amniotic fluid
● Protein reserves prepare the mother for
labor, delivery and lactation.
CALCIUM
● Growth and development of bones as
well as teeth of the fetus.
● Calcium intake decreases risk of
hypertension, pre-eclampsia in mothers
and low birth weights and chronic
hypertension in new-borns.
● Maintaining bone strength
● Proper muscle contraction
● Blood clotting
IRON
● Expansion of maternal tissues including
the red blood cell mass
● Maintaining additional iron content of
placenta
● Building the iron stores in fetal liver
● Compensate blood loss during delivery
VITAMIN REQUIREMENTS DURING PREGNANCY
● Vit B12 (1.2 ug/d) : Vitamin B12
sUpplementation during pregnancy
helps in brain & nervous system
development of the fetus.
● Vitamins A (600 g/d retinol): it is
needed in small amounts to protect the
fetus from immune system problems,
blindness, infections and death.
- Too much vitamin A results in problems
with the baby.
● Vitamin D (5ug/d): It is required for
formation of fetal bones.
- Vitamin D is really important especially
in the absorption of your calcium
because calcium is needed for the fetal
bones. Especially during the third
trimester of pregnancy, calcium is very
important because about 300 mg of
calcium is being transferred to the baby
daily. Because at that stage of
pregnancy, the third trimester, the fetal
bones begin to calcify. So that's why 300
mg is being transferred daily to the
baby.
- We also need phosphorus and
magnesium to strengthen the bones to
prevent rickets etc.
● Vit B6 (2.5mg/d): It is required for
normal fetal development & positive
pregnancy outcomes.
- We need it for DNA, synthesis, and
RBC.
● Vitamin K: Vitamin K is required for
normal coagulation of blood & prevents
newborn infants hemorrhages.
● Vit C (60mg /d): It increases iron
absorption and also helps in fetal
growth. Deficiency of vitamin C
decreases the chances of preterm
delivery.
● Vit B1 (+0.2mg/d), B2 (+0.2 mg/d),
● B3(+2mg/d): As total energy
requirement increases during
pregnancy so B vitamin requirement
also increases.
- The B complex is really needed in the
metabolism of the macronutrients.
- We need vitamin B complex to
metabolize the food that we eat.
VITAMIN AND MINERAL REQUIREMENTS
DURING PREGNANCY
Folic acid (Vit B9) (RDA- 400 pg/d):
 ● During pregnancy maternal blood
formation increases thus folic acid
requirement also increases
● Folic acid supplementation during
pregnancy prevents fetal neural tube
defects and improves birth weights of
the fetus.
- Folate to prevent NTD’S or neural tube
defects.
Minerals
● lodine: Lack of iodine causes stillbirth,
birth defects & decreased fetal brain
development. ( Just like in the case of
deficiency of iodine= cretinism
Zinc (RDA-12 mg/d) : For immunity and
synthesis of nucleic acid just like your DNN RNA.
- And it is very important in reproduction.
● It is required for synthesis of nucleic
acids DNA & RNA and it has an
important role in reproduction.
● Zinc deficiency during pregnancy can
cause poor pregnancy outcomes and
abnormal deliveries including
congenital malformations.
- Increased vitamin A will result in cleft
palate, microcephaly, mental
abnormalities, eyes and ears
abnormalities. ( small amount or wag na
kunin na lang sa pagkain)
- Prenatal supplements are needed but
not all.
- First trimester folate, B complex are
given as prenatal supplement
- Vitamin C is needed for the collagen
formation also para at least mas strong
ka during pregnancy and also for the
baby.
- Multi-vitamins also pero pag too much
and weight gain, hindi na masyado.
- But it is needed for clients who belong
to a high-risk group ang
supplementations natin na ang mga
mothers that are carrying multiple
fetuses, like twins, triplets, adolescents
mother, Smokers, kailangan ng vitamin
C, alcohol drinkers, drug abusers need
nila because they have inadequate
intake of nutritious foods-= stunting of
child
(PREGNANCY) NUTRITIONAL RELATED
CONCERNS ABOUT PREGNANCY
● NAUSEA- Digestive muscle, hormonal
changes, rapid stretching of
uterine,”morning sickness' '. ( Do not
drink milk and juices, citrus juice
because it triggers vomiting)( arise
slowly, consume dry toast or crackers
or any carb, suck hard candies or chew
gums avoid foul odor food)
- Rapid stretching= morning sickness
- Pag too much or severe yung vomiting
and nausea ng ating pregnant women=
Hyperemesis gravidarum.
- Nausea and vomiting of pregnancy that
may result in dehydration.
● HEARTBURN- Hormonal , relaxation of
the digestive muscle, Growing fetus
foot putting pressure on the mother’s
stomach, back up acid (Rest first before
drinking , avoid spicy, coffee and greasy
food and tell the mother to relax and
chew slowly the food. Avoid drinking
fluids immediately after eating. Sit up
while eating, elevate head while
sleeping. )
● HEMORRHOIDS- Hormonal imbalance,
poor motility in the digestive tract
(Increase progesterone and estrogen)(
Increase fluid intake and physical
activity)
- This is a hormonal imbalance just like in
nausea. It's an increase in progesterone
and estrogen levels.
 - Nausea may HCG pa diyan na
nag-increase.
- Constipation in hemorrhoids
nagkakaroon ng alteration kasi on
muscle tone because of these
imbalances that may alter or it slows
down the motility. Yung paggalaw ng
tiyan, mabagal and even the intestines.
So kaya nagkakaroon ng constipation.
- Expanding uterus, kaya nagkakaroon ng
hemorrhoids poor circulation going
there on the rectal mucosa.
- Strategies will be to increase fiber
intake, increase fluid intake, increase
physical activity.
- If there is an urge to defecate, respond
immediately.
● FOOD AVERSION OR FOOD CRAVINGS-
Hormone induce changes ( Non food
cravings- PICA) ( ex. Ice/ dirt)=
geophagia ( Iron deficiency anemia)
● GESTATIONAL DIABETES- Gestational
diabetes na nangyayari result of too much,
increase of weight din or may lahi ang
nanay.
OTHER CONSIDERATIONS DURING PREGNANCY
( PRACTICES INCOMPATIBLE WITH
PREGNANCY)
● Alcohol: During pregnancy alcohol
consumption causes low birth weight
infants & growth retardation, fetal
impaired central nervous system
performance including growth
retardation.
- If a mother who is alcoholic will deliver
a baby, the baby may have the FAS (
Fetal alcohol syndrome)
- FAS=Irreversible physical and mental
retardation
- Characteristics of a baby with FAS has a
small head, short eyes, flat midface, and
thin lips.
- Alcohol drinking may cause deficits in
the behavioral and social abilities on the
part of the baby.
- In mother nagkakaroon ng abruption of
placenta, placenta previa. PROM
(premature rupture of membrane) ,
decrease of appetite, infertility and
hypertension.
● Drugs: During pregnancy drugs
consumption lead to poor prenatal
weight gain, very short or prolonged
labor, operative delivery and other
perinatal problems or perinatal death,
preterm birth or SIDS( sudden infant
death syndrome)
● Smoking: During pregnancy smoking
results in placental abnormalities & fetal
damage, including prematurely & low
birth weights. Smoking impairs oxygen
& nutrient transport through the
placenta due to reduced blood flow.
- Limits the waste removal of the fetus.
- The caffeine should be limited to a
pregnant mother, to only 2 12 oz
caffeine-containing beverages. (
dalawang tig 12oz lang sa isang araw or
less than 300mg of caffeine. )
- Moderate to heavy use of caffeine may
increase spontaneous abortion.
- Spontaneous abortion= walang
ginagawa nalaglag si baby.
IMPORTANCE OF NUTRITION DURING
LACTATION
- For healthy teeth
- Lactation is the production of the milk
and the breast of the mother.
- All mother has the capable of doing it
 - Recommended month for breastfeeding
is 6 months to 1 year.
- The mammary gland is responsible for
secreting the milk.
- Prolactin is responsible for milk
production
- milk ejection with the sucking of the
infant is oxytocin
- With the help of the sucking of the it
initiates the release of the oxytocin.
- Milk will be ejected at the baby's mouth
and it is called your let down reflex.
- A fully established feeding routine takes
about two to three weeks.
- Minutes to breastfeed =10 to 15
minutes for each breast( to prevent
previous breast).
1. During lactation adequate nutrition is
required as the infant derives all its nutrition
from the mother's milk.
2. Mother needs extra nutrition as she has to
nourish a fully developed & rapidly growing
infant. She needs extra nutrients to meet the
baby's needs in addition to her own
requirements.
3. Any inadequacy in mothers diet influences
both the quality & quantity of mother's milk
secreted.
4. If a mother's diet is inadequate then she will
draw her own body reserves to meet the needs
of lactation at the cost of her own health.
5. Nutrient deficiency can lead to lower levels of
nutrients in the mother's milk.
BENEFITS OF BREASTFEEDING IN THE PART OF
THE BABY
● Lower risk of asthma
● Special bond between the mother and
the baby.
● Increase immune response of the baby
● Lowers the risk of obesity and the
sudden infant death syndrome.
● Your breast milk contains the right
amount of water, EFA, and AA that are
necessary for brain development and
growth and development.
● EFA= essential fatty acid
● AA= Amino Acid
● Lower the incidents of ear infection,
diarrhea and allergies
● It lowers the incidence of ear infection
kasi usually pag-battle fat ang bata,
nagkaka-otitis media.
● Growth of straight and healthy teeth
● Through sucking, it promotes good jaw,
growth of straight and healthy teeth.
● Babies receive immunities from the
mother because of the presence of
antibodies on the breast milk.
● It prolongs a minoria on the part of the
mother.
● It delays the return of ovulation and
lengthening birth intervals.
● Conserves iron stores for the mother by
prolonging amenorrhea. Conserves iron
stores for the mother by prolonging
amenorrhea, delays ovulation, and
lengthening the birth intervals.
● May protect the mother from breast CA
and ovarian CA
● Breast milk is economical and
cost-saving.
NUTRITIONAL REQUIREMENT DURING
LACTATION
Energy requirement
1. Lactating mothers need additional energy for
production of milk.
2. During pregnancy approximately 600-850 ml
milk is secreted daily.
3. Energy content of mother's milk and the
efficiency of conversion of food energy into milk
energy determines the energy requirement of a
lactating woman.
4. During first 6 months of lactation - additional
550 kcal/d energy is required
6. During 6-12 months of lactation - additional
400 kcal/d energy is required
- For the first 6 months, the mother will
produce about 35 gallons of breast
milk.
- The calorie requirement or the energy
requirement to produce 3.5 ounces of
milk, the mother needs about 85
kilocalories
- For the first 6 months, average milk
production is 750 ml or 25 ounces. So
the mother needs an additional calories
of 640 kcal per day.
- For the next 6 months or 6 to 12
months the average production is
about 20 ounces or 600 ml. So it needs
about 510 Kcal per day.
- So how frequently should the mother feed
the baby? For the first month, 8-12 times to
feed the baby
- For the succeeding gonna feed the baby by
demand kasi kumakain na ang baby.
Protein requirement:
1. During lactation protein needs also increase
as mothers milk contains 1.15g of protein/
100ml.
- The protein requirement during
lactation protein needs also increases
for about 1.15 grams because the
breast milk contains 1.15 grams of
protein per 100 ml. So kailangan niya
mag-increased din ng kanyang intake of
the protein.
2. For proper milk production, adequate
amounts of good quality protein or good quality
protein should be included in the mother's diet.
3. During first 6 months of lactation- 75g of
protein is required everyday
4. During 6-12 months of lactation - 68 g of
protein is required everyday
Nutritional requirement during lactation
● Protein requirement: During lactation
protein needs also increases as mothers
milk contains 1.15g of protein/100ml.
Adequate amounts of good quality
protein should be included in the
mother's diet. During the first 6 months
of lactation- 75g of protein is required
everyday During 6-12 months of
lactation - 68 g of protein is required
everyday.
● Calcium: 1g /d Additional calcium is
required for breast milk secretion.
30-40 mg of calcium is secreted per
100ml or 300mg of calcium per 850 ml
of milk. Additional intake of calcium is
essential to enable the retention of
calcium in breast milk. Adequate dietary
calcium intake during lactation meets
the mother's calcium needs and extra
calcium requirement for breast milk
production.
● Iron: 30mg/d Iron requirement during
lactation is the addition of the
requirement of the mother & required
to make up the iron secreted in breast
milk. Most of the lactating women
have lactation amenorrhea, resulting in
saving 1 mg of iron per day which
would otherwise be lost in the
menstrual blood. The requirement of
iron is same as the non pregnant
woman.
NUTRITIONAL REQUIREMENT DURING
LACTATION
● Vitamin A (950 g/d): Breast milk is rich
in vit. A so lactating mother needs an
adequate amount of vitamin A in their
diet.
 - Vitamin A is needed also for growth and
development. Not only for vision, for
growth and development because the
vitamin A is responsible in the
osteoclasts and osteoblasts of bones of
the baby
● Vitamin B6 (2.5mg/d): Its requirement
increases during lactation.
● Vitamin B12 (1.5mg/d): Additional
Vitamin B12 is required to meet the
needs of the lactation.
● Folic acid (150 g/d): Additional folic acid
intake will meet the needs of the
lactation
● Vitamin C (25m/d): Appreciable
amount of vitamin C is secreted in
breast milk. Additional intake will meet
the need of the lactation.
-For immunity
DIET AND FEEDING PATTERNS
1. Lactating mother requires larger quantities of
body building and protective foods & additional
energy yielding foods to facilitate the formation
& secretion of breast milk.
2. Fluid intake should be increased as fluids are
essential for adequate quantity of milk
production.
- Importance of fluid for milk production
and dehydration of the mother.
3. No food should be restricted except highly
spiced & strongly flavored food, as they impart
flavor to milk which may be repulsive to the
baby.
- No food should be restricted except
highly spiced & strongly flavored food
because they alter the taste of the milk
that results in the baby being repulsive.
Nagiging ayaw ng bata ang breast milk
mo
- Also avoid spicy food and smoking
because it reduces the milk volume.
Furthermore, the milk will contain
nicotine which alters the smell and
flavor.
- Limit your caffeine intake because it
makes the baby wakeful and irritable.
FOOD OFFENDERS
- Omit fish, cows milk, peanut, eggs
especially when baby has allergies
- If the infant will develop allergies,
symptoms of allergies are rashes, the
mother will omit the allergy and the
offenders just like your cow's milk,
peanut, fish, and eggs.
- Avoid alcohol. It alters the milk flavor,
suppresses feeding, and causes
sleepiness, and it inhibits the oxytocin.
- During pregnancy, avoid alcohol.
Because the amount of alcohol that you
are drinking is the same amount that
will be transferred to the baby via the
placenta. ( resulting in FAS)
- The baby inside the womb, the liver is
not yet fully developed. So, hindi ba
niya ba metabolize ang alcohol.
- So, at least the mother will have a food
intake of about 5-6 meals in a day. (
wag sobra tataba ang nanay)
4. Nutrient needs of a lactating mother are
greatly enhanced during lactation hence she
should have snacks in between the meals.
Lactating mother should have 5-6 meals in a
day.
NUTRITION ON INFANCY
• For a baby, breast milk is best. It has all the
necessary vitamins and minerals.
• The American Academy of Pediatrics (AAP)
strongly recommends exclusive breastfeeding
for the first six months of life and that
breastfeeding continue for at least 12 months.
• For babies BREASTFEEDING can protect
against
SIDS
• Increased intelligence,
• Decreased likelihood of contracting middle ear
infections, cold and flu resistance,
• A tiny decrease in the risk of childhood
leukemia,
• Lower risk of childhood onset diabetes,
• Decreased risk of asthma and eczema,
• decreased dental problems
• Decreased risk of obesity later in life,
• Decreased risk of autism,
• And a decreased risk of developing
psychological disorders, particularly in adopted
children.

● Day 1 It contains about 5-7 ml or 1

teaspoon size of a cherry
● Day 3 size of walnut, 22-27 ml or 0.75
to 1 ounce.
● One week size of an apricot 45-60 ml o
1.5-2 oz of milk.
● One month, the size of a large egg,
80-150 ml or 2.5-5 oz.